The "Childmyths" blog is a spin-off of Jean Mercer's book "Thinking Critically About Child Development: Examining Myths & Misunderstandings"(Sage, 2015; third edition). The blog focuses on parsing mistaken beliefs that can influence people's decisions about childrearing-- for example, beliefs about day care, about punishment, about child psychotherapies, and about adoption.
See also http://thestudyofnonsense.blogspot.com

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Tuesday, December 31, 2013

Yesterday I discussed some issues about adoptive
nursing-- breastfeeding a child who is
in one’s care but who was born to a different mother. I concluded that adoptive
nursing can be valuable for the health of very young babies or others who have
poor immune reactions to infection, but that it is irrelevant to the social and
emotional development of the child, and relevant to mothers’ emotions only in
that they may expect it to influence their relationship with a child.

Today, I want to look further into advice about
early emotional development as it is given by proponents of adoptive nursing
like Alla Gordina and Karleen Gribble.
These authors, as well as Gordina’s colleague Ronald Federici, propose
that it is essential for adopted children to experience complete dependency on
their new parents. For example, Gordina says in her PowerPoint presentation (www.wiziq.com/tutorial/693267-ADAPTIVE-NURSING-APC):
“Promote dependency on you providing food for your child (hand/finger feeding by
caregiver even for snacks, feeding/drinking in the breastfeeding position
and/or on caregiver’s lap, bottle feeding, eye contact, etc”. She also says (without further explanation in
the PPT): “Not to give such a child a sippy cup; use a bottle with the hole as large
as the child needs, slowly decreasing the opening; straw cup or a regular cup
can be used too”. Bottle-feeding for all
ages is encouraged.

What is the reasoning here? Why would either
breastfeeding, or continued bottle-feeding of an older child, be expected to
benefit the child’s emotional development? This viewpoint, shared by Gordina, Gribble,
Federici, and others, seems to be part of a naïve psychology that expects
imitation or re-enactment of desirable events of early life to have positive
effects, as if they had really occurred
early on. This is a form of magical thinking in which symbolic actions are “mapped’
onto actual events, and the outcome of a ritual is expected to be the same as
the outcome of the real occurrence. Similar thinking can be found in various
alternative psychologies and psychotherapies like the screaming and convulsing
of “primal therapy” and the apparently-painful infant massage done by people
like William Emerson.

Specifically, the rationale for associating breast-
or bottle-feeding with attachment would seem to be the following: Young infants
who are breastfed or bottle-fed are completely
dependent on their caregivers and indeed would not survive without adult care.
Such infants are still completely dependent some months later, when they start
to show signs of attachment behavior to their familiar caregivers. Therefore
(and here’s the tricky part), the dependency must have caused the
attachment-- so, if dependency can be
fostered in an older child, that child will also show attachment as infants and
toddlers do. In addition, if that child can be made to appear like a dependent
young child by replicating breast- or
bottle-feeding or other infant care routines, he or she will actually BE
dependent, and therefore (again) become attached and show this as younger
children do.

When the rationale is spelled out like this, it’s
clear that it resembles the thinking behind rituals like the couvade or like spitting if someone
compliments your child, so evil spirits won’t get interested.

But there’s more. Looking at remarks by Karleen
Gribble (https://www.breastfeeding.ans.au/bf-info/adoption),
we can see another reasoning problem behind some of the claims of adoptive
nursing advocates. Gribble says: “…it is important to bear in mind that the
emotional and developmental ages of a child may be very different from their
chronological age and that breastfeeding can help nurture the baby inside the older body” (my italics-- JM).
This view is common among “attachment therapists” and others whose work
is not evidence-based, especially therapists who are focused on multiple
personalities or dissociative conditions. The concept of independent entities
within a personality has many sources, but the idea of the “Inner Child” was
popularized in the 1970s as part of Transactional Analysis. The posited need to
care for this entity goes back much further to “wild psychoanalysts” like
Sandor Ferenczi.

The belief that some “inner baby” needs to receive
care suitable for an infant is an aspect of a “parts” psychology that ignores
the integration of components of any person. Of course a child may act in
some ways as if he or she is younger than is chronologically the case, but this
does not mean that the child has younger “parts” that need care different from
what the whole child needs. To assume this ignores the whole nature of the child, and resembles thinking that a 20-year-old
with an IQ of 50 would do well in a school class of 10-year-olds with IQs of
100, or that a 15-year-old who behaves “childishly” should be given a time-out.

An adopted 5-year-old may seem emotionally “young” or
“immature” when he or she has trouble resisting temptation or tolerating
frustration, but that child does not have an “inner baby” who needs special care.
Instead, the child is a person with many typical 5-year-old abilities who is
having difficulty mastering some emotional capacities. To treat such a child like
a baby (unless this is what he asks for) is to dismiss his most mature
capacities as if they did not exist, and thus to remove points of pride and the
senses of autonomy and initiative that are characteristic of his developmental
stage. This situation is similar to one in which the 5-year-old has difficulty
using speech; high-pitched, repetitious infant-directed talk is suitable and
useful for an infant to hear, but however poorly the older child may speak, he
is beyond the stage when infant-directed talk will help him, and needs support that is appropriate
for his entire developmental picture.

Again, I want to be clear that I am not rejecting
adoptive breastfeeding, and I believe it can be very appropriate for babies
with some medical conditions or with poor immune reactions. However, the social
and emotional reasons claimed for it are without grounds.

One final point: Gordina’s PowerPoint gives one
piece of advice which I wish could be given to all parents, adoptive or
otherwise. She says, “Not to stare on your child, while he/she is eating unless
you and he/she are ready to initiate the eye contact”. I’m not too sure what
that last part means, or how you would know this readiness, but I’m convinced
that the anxious stares of parents have exactly the opposite effect from what’s
wanted. Babies don’t like blank or frightened-looking faces and are likely to
avert their eyes and avoid looking at a staring adult. If you find you are
staring, try “flirting” instead-- look
away, glance back, look away again, and keep smiling until the baby gets
interested in you. That’s how you get relationships rolling.

At the end of the war in Vietnam, there was some
publicity about the fact that staff caring for babies who were to be airlifted
to the U.S. took medications that caused them to lactate so they could feed
infants in the absence of their usual food supplies. Over a number of years,
there has been increasing emphasis on the idea that adoptive mothers can
breastfeed their babies-- and that if at
all possible they ought to do
so. One person who has pressed this idea
is Alla Gordina, a Russian physician who practices in New Jersey. A PowerPoint by Gordina can be seen at http://www.wiziq.com/tutorial/693267-ADAPTIVE-NURSING-APC.

Although she includes in the PPT instances where an
adoptive mother was unsuccessful or unhappy with breastfeeding, Gordina
stresses the benefits of adoptive nursing and focuses on social and emotional
as well as biological factors. She refers to the practice as “adaptive nursing”,
followed by “TM”, so it would appear that she has trademarked this term (?).
Her PPT lists some of the advantages of adoptive nursing in the following
order: promotes secure attachment and trust; augments their sensory and
physical development; provides a therapeutic effect on the correction of oral
deficits and/or aversions.

Gordina discusses a number of general practical
issues about feeding children adopted from institutions where they might have
received poor care, including fears they may have if they have been fed roughly
or insensitively. These are important considerations, but my concern today is
to discuss the statements she makes about the social and emotional aspects of
breastfeeding.

Breastfeeding
and attachment. Emotional attachment of young
children to their caregivers is based not on food but on the sharing of
pleasant social interactions and play. For young infants, most of those
interactions ordinarily center around physical care routines, including
feeding. These are the events that happen most often in the infant’s day and
are always a time when another person is present to socialize (except when
people prop bottles, but let’s not think about that). They are also times
when the caregiver is focused strongly on the infant and is not doing much
else, although of course there may well be side activities, conversations
with others and so on. Pleasant social interactions often occur during
feeding, when the baby eats enthusiastically and the caregiver is pleased
to see this.

However, it makes no
difference to social interaction whether the young child is breastfed or
not. Any feeding method or routine can be linked with pleasant shared
experiences and communications. These are
the real basis of attachment: attachment
is not the “cupboard love” proposed in
the past, but involves satisfaction of a hunger for social contact. Otherwise, young children would
not become attached to their fathers, brothers, sisters, grandmothers and fathers, nannies, and child care
providers-- which they do.

Initially, attachment
is shown as a sense of safety and security associated with familiar people, and
many authors, including Gordina, have jumped to the conclusion that attachment
at all ages is shown by “staying near”. But as children get older, their
attachment to adults is expressed in terms of new developmental needs such as
needs for autonomy and the ability for independent actions. Pleasurable
experiences with adults involve children’s pride in their new abilities, not
the sense of happy dependency that was evident earlier. Bowlby’s attachment
theory stresses the growth of a
“goal-corrected partnership” in which the maturing child and the parent
gradually shift their ways of interacting to satisfy the developing needs of
both and to preserve their relationship--
not simply to preserve dependency.

(It’s interesting, by
the way, that Gordina refers to the possibility that adopted children will have
“Developmental Trauma Disorder”, a diagnostic category that remains poorly
defined and “unofficial” in spite of recent attempts to bring it into use. )

Breastfeeding
and bonding. The term “bonding” is best used to
describe the powerful positive feelings and intense interest of a parent
with respect to a young infant. Writing decades ago, Klauss and Kennell
originally used the term “maternal-infant bonding” to refrer to this, but
for the second edition of their book chose the term “parent-infant
bonding”. In that second edition, they also attempted to correct the
misunderstanding that bonding occurred instantaneously for all parents or
even for mothers alone, or that all aspects of the parent-child
relationship were somehow determined by some bonding event soon after
birth.

Nevertheless, quite a
few people continue to assume that some event pushes a button, which causes
bonding, which in turn causes good parenting. The events that push the button
are usually expected to be related to “primitive” or “traditional” folkways.
They include an emphasis on skin-to-skin contact and of course on breastfeeding
immediately after birth (although in fact a number of “traditional societies” do not let the baby
nurse at once and regard colostrum as dirty, and many others have traditionally
swaddled the newborn, making skin-to-skin contact minimal). The actual association of such experiences with
parental attitudes and with effective parenting has never been
demonstrated. It seems most unlikely
that there are such associations, as human beings care for and feed infants in
a wide variety of ways, usually with good outcomes-- just as they feed both children and adults on
a wide variety of diets.

It’s thus improbable that breastfeeding causes
bonding. However, if mothers are told that they cannot do a good job caring for
their infants unless they breastfeed, wear purple for the first year of the child’s
life, or play pinochle regularly throughout the third trimester, they are
likely to believe these things because of their strong wish to do well. If they
are told that breastfeeding will make them bond, and that without it their
feelings for the child will be fragile, they will be distressed by any
“failure” they experience.

Gordina’s presentation
notes the needs of adoptive mothers who have been distressed by infertility,
miscarriage, or infant death, and suggests that successful adoptive nursing can
help them recover from these traumatic experiences. She does not support this
statement with evidence, nor does she examine in this PowerPoint the possible
effects of lack of success either in lactation or in nursing. Given a mother
who has never breastfed or even been pregnant, and a baby who has learned to
suck an artificial nipple (a different suck-swallow pattern than is used at the
breast), the chances of experienced failure can be pretty large.

Breastfeeding
and older children. Gordina’s PowerPoint
references Karleen Gribble, an Australian nurse who has apparently
recommended breastfeeding for adopted children as old as school age, and who
says that it may take as much as a year for breastfeeding to be
accomplished (https://www.breastfeeding.asn.au/bf-info/adoption).
Curiously, Gribble also notes that a child may need to attach before being
abIe to nurse, but that at the same time nursing supports attachment.

I am far from opposing
toddler nursing or even culturally-appropriate nursing of older children who
have been at the breast since birth, but there are some obvious difficulties
for children who were bottle-fed from an early age. One is, as I mentioned in
the last paragraph, that these children have learned to suck and swallow
differently when using a bottle than they would have if breastfed exclusively.
(If the latter, of course, they would not have learned how to nipple-feed and could
have a difficult time adapting if suddenly weaned from the breast before they
drank from a cup.) A second problem is that most children learn by preschool
age that breasts are “private parts” and are not to be touched—most adoptive
parents, in fact, would be very concerned and speak of sexualized behavior and
even a history of sexual abuse, if a child touched the adoptive mother’s breasts.

Incidentally, Gribble
and Gordina both allude to adopted children showing their wish for breastfeeding,
but they give no details that I can find, nor does there seem to have been any
systematic investigation of this issue.

So, am I saying that
there is never any good reason for adoptive nursing? No, indeed. Breastfeeding
has some real physical benefits in terms of development of the jaw and
resistance to infectious diseases. The breastfeeding mother’s mature immune
system serves as an auxiliary support to the immature infant’s reaction to
infection, and this can be very important for babies who are poorly nourished,
exposed to many infections, or in a dirty environment. When breastfeeding can
be established for the young adopted baby, there will be real physical health
benefits. It’s also beneficial that a mother enjoys nursing and that families
may regard the nursing relationship as a more “real” connection than any other.

But what about
attachment, security, and other emotional benefits? No, these are not reasons
to do adoptive nursing, because they are not based on breastfeeding in any
case.

Tomorrow, I want to go
on to talk about some of Gordina’s views on the need for child dependency, and
on her connections with other authors like Gribble who propose that older
children need to be treated as if they were infants.

Wednesday, December 18, 2013

A reader commented the other day that water births
were sometimes said to be less painful for the mother than ordinary births. If
there were any evidence of that advantage, it’s easy to see why women would
want to choose the water method-- but in
fact there is no evidence. Of course, the water birth guru I.B. Charkovsky and
his followers have claimed that women giving birth “his way” experience lengthy
orgasms, suggesting painlessness at the very least (as well as suggesting that
Charkovsky assumes there is a sucker born every minute who becomes ready as an
adult to buy his beliefs).

My thanks go to Yulia Massino for discovering more
information about water births as
approved by the Association for Pre- and Perinatal Psychology and Health
(APPPAH). At http://www.birthintobeing.com/index.php?option=com_content&view=category&id=85&Itemid=482,
one of Charkovsky’s protégées, Elena Tonetti, speaks of having been welcomed as
a speaker at an APPPAH conference, and on another part of the birthintobeing
site quotes the praise of Thomas Verney, author of The Secret Life of the Unborn Child, a piece of fantasy following
the beliefs of the “wild psychoanalyst” Nandor Fodor, and a founder of APPPAH.
(I am emphasizing this APPPAH connection to show that the problems of beliefs
about water births and similar practices are a world-wide problem, not just a
peculiarity of Russians.)

In a passage written by Tonetti on the
birthintobeing website, we see an explanation of Charkovsky’s belief that water
births are advantageous for babies: “The idea to place laboring women in the
water came to him [Charkovsky] when he was looking for the ways to relieve a
baby’s brain from the shock of gravity. He considered this the main reason why
the human brain is not fully available for our use. He states that whales and
dolphins have a much better use of their brains, on levels unreachable for
humans, because they are not exposed to gravity shock at birth. As proof of
their higher intelligence and superior use of their brain, Charkovsky points
out that these animals are not territorial and do not kill their own. He
suggested that the concussion human beings experience as we emerge from the weightless
environment is far more devastating than we care to understand. By the time we
grow up and the function of understanding is available to us, we have no
reference point to compare our brain power to what it could have been if we had
not been, literally, smacked on the head by the immense pressure of our earthly
gravity.”

Let’s look at this explanation painful line by
painful line, because reading the whole thing at once produces the smack-upside-the-head
sensation equivalent to what Charkovsky posits for babies:

“… he was
looking for the ways to relieve a baby’s brain from the shock of gravity”.

Charkovsky is apparently unaware that gravitational
attraction is acting on all objects close enough to a planet, whether or not
they are floating in water. He seems to conflate floating in water with
floating in space in a zero-gravity environment. If gravity were not at work on
all objects, everything including the water would fly off into space. The sense
we have of lightness when in water has to do with the water supporting our
bodies against the pull of gravity, thus making limbs movable with less
muscular effort, but the support of the water is different only in degree from
the support offered by the floor or a bed. That gravity is still at work for
the unborn baby or one in the birth process is shown by two obvious
things-- first, that most unborn babies
move into the head-down position, the weight of their heads being a major
factor in this movement, and second, that even Charkovsky wants birthing
mothers to be upright rather than reclining, so that the baby is helped to move
downward by the pull of gravity, rather than “uphill” as would be determined by
the slant of the vagina if the woman is lying down. Can even Charkovsky believe
that gravity is operating on the body of the infant but not on the brain?
Perhaps he has some concept of brain levitation that has not been included
here, but otherwise the logic escapes the reader. Gravity is acting on the
brain in the same way from conception to birth and after birth as well,
therefore there is no “shock of gravity” to be experienced.

“…the
main reason why the human brain is not fully available for our use.”

Here we have one of the most common errors of
understanding of brain functioning, the old “only 10%” misconception. It may
well be true that only 10% of the brain is used for cognitive functioning, but
absolutely essential tasks are performed by the remaining 90%. The brain
analyzes visual and auditory input with large areas, organizes and sends
signals to muscles to create all voluntary movements, and monitors and controls
vegetative functions like blood pressure and salt-water balance. The parts of
the brain that do those critical jobs are specialized for their own tasks and
cannot be recruited to do cognitive work. We humans may not be as clever as we
would like to be, but it is not because we do not use our whole brains. We don’t
need to look for a reason why we don’t use our whole brains, because there is
no truth to this notion.

“…
whales and dolphins have a much better use of their brains, on levels
unreachable for humans…”

Romanticizing the intelligence, goodness, and
benevolence of marine mammals is an interesting residue of the ‘60s and ‘70s,
when John Lily claimed to be able to understand and use dolphin languages, and “whale
music” for nurseries was much in favor. Swimming with dolphins and even dolphin
therapy remain with us as alternative psychotherapies with unsupported claims
for treatment of autism and other disorders. That these animals use their
brains more effectively, or have cognitive capacities superior to those of
humans, has not been demonstrated--
although of course it is true that in their natural environments they do
much better than a human being could do, just as we do better than they could
in our environment.

“…[they]
are not territorial and do not kill their own”

Desirable as such traits may be for human beings, there
are two problems here. The first is that differences in aggressive behavior
between different species can be very strong, and to make the same claim for
all whales and all dolphins is inappropriate. In addition, many claims about
the nonaggressive behavior of specific animals, for instance that gorillas and
other primates did not kill for food, current in the 1960s, have not turned out
to be correct upon further observation. Second, assuming for the sake of
argument that whales and dolphins are peaceful, there is no reason to think
that human beings can gain this characteristic by imitating one chosen behavior
of those species; if such imitation could be helpful, why not imitate eating
plankton or fish, or going naked at all times?

“…far
more devastating than we care to understand”

Here we have a typical argument of the
pseudoscientific ilk. Rather than disagreeing with the logic or facts of Charkovsky’s
views, or even simply failing to understand, opponents must be actively
choosing their opposition because they do not want to understand. This choice
would presumably be made because of their distorted thought processes and lack
of intelligence, caused by their birth experiences-- just as those who oppose “attachment
therapies” are said to suffer from attachment disorders. I suppose we could
call this rhetorical device “proof by diagnosis”.

“…
no reference point to compare our brain power to what it could have been…”

This is very true, but omits to say that Charkovsky
& Co. also have no reference point except their own unsupported claims.

Well, there you have it-- the incredibly faulty reasoning behind the belief that being
born in water is beneficial for infants’ development. And of course this
reasoning assumes that the child survives the experience, which according to
news reports has not always been the case.

Monday, December 16, 2013

Over the last few weeks I have been sent a lot of
news by Yulia Massino and Nina Sokolova, two Russian women who are very
concerned about potentially harmful “New Age” practices related to childbirth
and child-rearing. Much as I sympathize with these problems in Russia, I’m
equally disturbed about the fact that the United States is also home to related
belief systems and practices. The less centralized government of the U.S. may
make it even more difficult than it is in Russia to regulate treatment of pregnant
women and infants in ways that will prevent harm, and American views of
tolerance for religious-based practices may have a similar effect.

For those of us with little or no Russian, being at
the mercy of Google Translate can make news from Russia quite confusing. For
example, the name of a Russian birthing center is translated as “erysipelas”
(an unpleasant skin disease), which has nothing to do with any of the problems
to be dealt with. However, with repeated readings some information does filter
through.

First, let’s have a look at the practice of “water
births”, as espoused by a number of earlier mystical thinkers like Mme.
Blavatsky, but practiced in the 1980s by one I.B. Charkovsky (see https://translate.google.ru/translate?sl=ru&tl=en&js=n&prev_t&hl=ru&ie=UTF-8&u=http%3A%2F%2Flena-malaa.livejournal.com%2F45160.html&act=url.
As all observers of the “New Age” know, this technique involves having the
laboring mother more or less immersed in water, so the baby emerges into a
water environment. As humans are lung-breathers, this situation would be fatal
if the baby were kept underwater too long, but in fact, because there is no air
in the uterus, at birth the infant has its lungs and respiratory passages
filled with amniotic fluid and mucus. Although much if this fluid has been
squeezed out by pressure during a vaginal delivery, babies usually need some
help in draining and suctioning the liquid that impedes breathing of air. Born
into water or air, the baby has the same possibility of needing assistance to
start breathing air. (Anecdotally, I’ve come across some accounts of infants
being slow to start breathing on their own if born into warm water, but I know
of no systematic study of this issue.)

What was Charkovsky’s reasoning about water births? The claims for both spiritual
and physical benefits were numerous and can be seen at the link given above.
(One interesting one is the idea that women giving birth in water experience
orgasms at the time; I will leave this ludicrous suggestion to the imagination
of women who have had babies.) Having persuaded himself and others that water
births were beneficial, Charkovsky carried his reasoning further, to claim that
sick infants and children could be cured by repeated immersion in icy water,
and that this would prevent or cure mental retardation. The immersion is
repeated rapidly with scarcely the opportunity for a breath between dips, thus
closely resembling the torture practice of “waterboarding”.

I don’t think we have to fall for the idea that all
problems are caused by trauma to realize that such a practice has the potential
for powerful traumatic effects. It’s clear that newborn babies, especially less
mature ones, can respond to being chilled with a cascade of internal responses
that can include brain damage from increased blood flow toward the brain and
death of intestinal tissue from a reduced blood supply there. As for older
infants and children, the terror of this experience must be greatly multiplied
by the awareness that a parent is nearby and does not stop what is happening. Why,
then, would any parent choose this treatment? Part of the answer presumably has
to do with the sad readiness of desperate parents to follow any guru who offers
hope, but in addition I think we have to look to common metaphors of
contamination as the cause of illness and washing as a health measure-- and these we see in the myth of Achilles, who
was dipped into a river to make him invulnerable (except that that heel did not
get wet), or in the custom of baptism by total immersion. These familiar ideas
may prepare parents to accept what would otherwise be seen as a bizarre and dangerous
practice.

Another practice advocated by those who recommend water
births is “baby yoga”. The link above contains very disturbing photos of
extremely young infants whose limbs have been forced into “yoga postures” (and
I should point out that in the newborn the hips are not nearly as flexible as
you might think, with a limit on the movement of the leg that gradually
decreases until at 5 or 6 months the
baby can pull the foot to the mouth ). How this was done, or what the occurrence
of hip dislocations was, is not made clear.

But there is even more to “baby yoga” than this.
Some readers will already have come across the claim that babies can be made
extra strong by adults who essentially fling the babies around, holding on by one hand or one foot as the baby
shrieks. A discussion and some footage of this can be seen at http://www.thedoctorstv.com/videolib/init/6483
(why do these guys have to wear scrubs to be on TV, I wonder?). Elena Fokina, a
proponent of “baby yoga” and of Charkovsky’s methods, is presently the subject
of an on line petition: http://www.thepetitionsite.com/978/068/511/stop-lena-fokinas-pracitce-of-baby-yoga/.
(Yes,”pracitce” is what it says.)

Unfortunately, the criminal charges for the shooting
incident described in the link above were not emphasized in a Daily Mail (www.dailymail.co.uk/news/article-2471806/Rusian-breastfeeding-expert-arrested-cult-leader.html)
article that claimed that breastfeeding was an uncommon practice in Russia and
that Tzaregradskaya was being hounded for encouraging breastfeeding rather than
for persuading families to avoid medical care. This was, I think, less a matter
of reportage than of carrying on with the current cross-fire of political pop-guns
between Russia and the West.

Obviously, Russia has some difficulty controlling
practices that are potentially dangerous to women and children, but that are
easily framed as “ancient wisdom” or “the ways of our ancestors”. What about
the United States? Do we have similar difficulties? Yes, and many of them also
derive from what is now called the “New Age”, but is actually identical with
the “New Thought” of the 1880s (yes, that’s the correct century). ( Some others,
like the advice of Michael and Debi Pearl of Tennessee or of the now-diminished
“Baby Wise” group, are descendants of Calvinistic views of submission and
obedience to parents as analogous to the Christian’s submission to God. ) Among
the “New Age” group the paramount organization is the Association for Pre- and
Perinatal Psychology and Health (APPPAH), whose members have fostered Lloyd
DeMause’s beliefs in the “poisonous placenta” and its psychological damage as
well as the position taken by Stanislav
Grof that LSD or oxygen deprivation could yield true pictures of experiences
during gestation and birth (rather than images of what someone imagined
gestation and birth to have been like). The APPPAH member David Chamberlain has
claimed that all children recall all the details of their births and even
earlier events, while another member, William Emerson, specializes in massaging
young infant’s heads and necks so they will re-experience the pains of their
birth and “cry out” those traumas. Emerson’s viewpoint is an example of the
belief held by some of these people, that infant crying is a necessary way of
getting rid of negative emotion and should not lead to attempts to comfort or
soothe the baby—an ideal of indifference to the child that also seems displayed
in the Charkovsky cold-water method.

State laws in the U.S. do not prohibit the teaching
of most such beliefs or the use of potentially dangerous methods for birth or
for child-rearing-- especially if it is
claimed, as it is both here and in Russia, that there is some religious
principle associated with a practice. Although it would be possible for
professional organizations in medicine and mental health to ban the use of
these methods by members, and to make efforts to educate the public about the
practices, this has only very rarely been done. In fact, the ethics code of the
American Psychological Association discourages such moves by requiring
psychologists who object to a therapy to speak directly to one of its
proponents in an attempt to resolve the conflict, rather than ”going public’.

A prominent Russian thinker has used the term “victorious
occultism” to describe the situation in Russia. We’ve got it here, too, and the
only way out I can see is for concerned people to speak up loudly.

Thursday, December 12, 2013

Everybody knows that medical and surgical treatments
can be frightening, humiliating, and painful to undergo. When there’s evidence
that they are effective, though, we grit our teeth and make ourselves go
through with them. Parents may have to make decisions to put young children through
very distressing treatments, without being able to explain the reason to them,
and as an article in the most recent issue of Zero to Three points out, the experience may be traumatic for the
child.

But let’s suppose that the treatment we are talking
about is not medical or surgical, but psychological or behavioral. If those
treatments are frightening, humiliating, or painful, is that acceptable? The German
psychologist Michael Linden recently wrote that such experiences created
additional “emotional burdens” for patients, and that if there were an
effective treatment that was not frightening, humiliating, or painful, it would
be completely unethical for a therapist to impose those burdens. Where some
degree of fear is likely to be experienced, as in desensitization treatments
for anxiety, therapists do their best to offer support and make the experience
bearable for the patient. Humiliation and pain are not normal parts of most
mental health interventions, and painful aversive treatments are expected to be
used only when a behavior is uncontrollable and dangerous enough to justify
deliberate causing of pain.

There seem to be a lot of rules about not distressing
adult psychotherapy clients-- but many
clinicians of various disciplines seem much less concerned about frightening or
hurting children. In fact, there seems to be a whole school of thought that
holds that pain and fear are needed to cause psychological and behavioral
change, or at least that they are harmless byproducts of such change. I’ve
repeatedly referred to the various schools of “holding therapy” as having this
position, but it appears that there are a number who share these attitudes
among professionals whose focus is not on mental health.

Ute Benz’s edited book Festhaltetherapien notes a similar viewpoint among occupational
therapists in Germany. In Benz’s chapter in that book, she describes how she
was contacted by a number of teachers and others who were disturbed by hearing
about occupational therapists doing a
form of holding therapy, KIT or Koerperbezogen
Interaktions-Training (body-related interaction training). According to one
commenter, in KIT the child is ultimately forced under the control of the
mother by physical and emotional contact; he goes on to say that for many children who could trust no one, this
method gives a helpful lesson in the persistence of love. The commenter also notes how much sincerity
it takes to restrain a child who fears or hates you, who screams, curses,
complains, cries, scratches, bites, pees his pants in self-defense and despair.
I would point out that such last-ditch
defense behavior is unlikely unless a child is frightened or hurt, and that
fear and pain are apparently tools of the “sincere” KIT therapist.

Authors in Benz’s edited book also refer to the “Vojta
method” which had been [happily] unknown to me. This method was originally
developed for treatment of the spasticity resulting from disorders like
cerebral palsy, but is now promulgated for a range of other problems, including
those of children and even newborn babies. The website www.vojta.com notes that “The therapeutically
desired activated state often expresses itself during treatment in newborn
babies as crying. This understandably leads to parents feeling concerned, and
makes them assume that it is ‘hurting’ their child. At this age, crying is an
important and appropriate means of expression for the little patients, who
react in this way to unaccustomed activation. As a rule, after a short familiarization
period, the crying is no longer so intense, and in breaks from exercise as well
as after the therapy, newborn babies calm down immediately. In older children
who can express themselves in speech, crying no longer occurs.” However, the
following clip of treatment of a three-year-old, who is old enough to talk,
appears to contradict this claim [N.B. This is quite a distressing
display-- please do not watch it while
children can hear or see]: www.youtube.com/watch?v=GrtF415N3Gc.

Yulia Massino kindly sent me materials about advertisement
in Russia of the Vojta method and the collection of funds for parents who want
to take their children to Germany or the Czech Republic for treatment (e.g., http://forum.sibmama.ru/viewtopic.php?t=830157-- in Russian,so please use a translation service
if you need to). Vojta therapy is also advertised in English, but apparently
not in the U.S.

Yulia also sent information about Elena Fokina’s
method of treating children, including young infants, by repeatedly plunging
them into cold ocean water, as well as by throwing them around in the infamous “baby-yoga”.
Here is an account of Fokina’s “swimming” methods by an observer: http://www.liveinternet.ru/users/nianfora_n/post220258301
(again, in Russian). There is no recording of screaming here, but I warn you
that this account disturbed me considerably even though I spend much of my time
reading about horrible treatments.

Can these frightening and painful treatments be
effective therapies for any childhood problem, physical, neurological, or
psychological? They do not offer anything but anecdotal evidence to support
their claims. However, as a general rule, sensitive and responsive parenting methods have been shown to nurture good
development, and rough, insensitive treatment to have the opposite effect. Psychotherapies
for children are often (whether correctly or incorrectly) thought of as
operating in analogy with good parenting methods. There seems to be no
rationale for inverting this analogy so that good therapy would imitate bad
parenting methods. The obvious conclusion is that neither research nor theory
supports the use of methods that frighten and hurt children. On the contrary,
these methods involve an “emotional burden” (as Linden had it) that can be expected
to exacerbate old problems and create new ones.

What sources can such actively harmful treatments
have? KIT and Vojta therapy appear to share with the often-rejected American method of “patterning” the view that imitation of early behavior and events will cause
those aspects of development to “re-wind” and re-play in a more typical
fashion. In both cases, and in other methods pushed by the Association for Pre-
and Perinatal Psychology and Health (APPPAH), crying in pain is either
dismissed as “expression” or encouraged because of the belief that it erases
memories of earlier distress. In these and similar techniques, there may also
be a metaphoric glance at exorcism, where a fight with demons, and the distress
of the possessed person, are necessary before healing can occur.

Fokina’s cold-water plunges and baby-yoga are more
difficult to comprehend. Are these simply the sadistic acts of a woman whose
personal charisma attracts the adulation of people who are desperate for a guru
and supernatural guide? Is it all just the culmination of a commercial enterprise?
I’m at a loss to say, but there seems to be no shortage of parents who will pay
someone to tell them to do cruel and pointless things to their children.

What happens with these treatments is not, as the
Vojta method author says, “hurting”. It’s
hurting with no quotation marks. And therapy for children should not hurt,
unless there’s a very good reason.

Monday, December 9, 2013

I happened to be reading The great derangement by Matt Taibbi, the Rolling Stone contributing editor, with an eye to seeing his
comments about how Congressional rules have changed-- when I saw that he also included an account
of being an “undercover atheist” in a weekend encounter group/retreat run by
the Texas Cornerstone Church. As I mentioned in my last post about a German
therapy weekend, these things all follow a predictable pattern, even though
details about family constellations or speaking in tongues may be different.
But Taibbi interested me by speaking of a concept put forward by the minister
leading this weekend, one Philip Fortenberry.

I’m about to say how Taibbi described this concept,
but I must note that I have only his description to go on. The Cornerstone
Church website alludes to it slightly, but my search of the Internet has not
revealed any other information about it. The basic idea, however, is identified
in this way by Taibbi: “The program revolved around a theory that Fortenberry
quickly introduced us to called ‘the wound’. The wound theory was a piece of schlock
Biblical Freudianism in which everyone had one traumatic event from their
childhood that had left a wound. The wound necessarily had been inflicted by
another person, and bitterness toward that person had corrupted our spirits and
alienated us from God. Here at the retreat we would identify this wound and
learn to confront and forgive our transgressors, a process that would leave us
cleansed of bitterness and hatred and free to receive the full benefits of
Christ” (pp. 70-71). Identification of the wound was apparently carried out by
recounting personal stories in small groups, and cleansing proceeded on the
final day through a service in which people spoke in tongues and vomited up
demons.

The connection between being wounded and filled with
hate and having to get rid of indwelling demons may not be obvious to non-charismatics,
but there is a logic when the omissions are filled in. Cruel actions and hatred
or pain attract demons, who in turn prevent the afflicted person from being
filled with the Holy Ghost (I am referring here not to Taibbi’s account, but to
various materials about charismatic thinking.) Being cleansed of the demons, it seems, causes
one to be cleansed of the aftereffects of the ‘wound’, including the hatred and
bitterness that attracted the demons to begin with. (I am not sure where
forgiveness comes into the picture, but in the “family constellation therapy” I mentioned in the previous post, hurt people
are asked to beg the forgiveness of those who have hurt them; this includes
sexually-abused children, who are to beg the forgiveness of the abusing adult, and,
no, I don’t have this backward.)

The parallel with Nancy Verrier’s “Primal Wound” is
easy to see. For Verrier, the important “wound” is the one she believes to take
place when an infant is separated from its birth mother, to whom (according to
Verrier) the child has already established a prenatal bond. Adoption by another
family is accompanied by the ill effects of the separation wound and makes it
impossible for adopted individuals to be truly happy. Verrier recommends that
all the details of the separation and adoption be discussed in order to have a
good developmental outcome, but does not suggest any therapeutic approaches
that could support this (and indeed she has been criticized by otherwise-accepting
authors for her failure to offer guidance on this point).

How does the PW compare to “the wound”? It’s a
specialized form of wound, occurring under specific circumstances, and not to
be found in most of the population. However, it otherwise parallels the “wounds”
posited by Fortenberry. It occurs in early life and hangs on, accumulating ill
feelings, and interfering with ordinary happy life. According to advertisements
for Verrier’s other book, Coming home to
self, people with childhood traumas feel they are living “unauthentic” (sic) lives, just as those with Fortenberry’s “wounds”
feel they need to “know the truth” and “be set free”. If Verrier did not base
the PW on the “wound”, or vice-versa, the two must be descendants of the same
belief system. And of course they both resemble closely the Scientological
practice of “clearing engrams” acquired before birth and in early postnatal
life.

One more interesting point about the PW:
charismatics too give adoption a privileged position as a cause of emotional
distress. For them, the circumstances behind adoption-- lust, unwanted pregnancy, accident or
illness, infertility, or death of a parent--
all attract demons to the adopted person as well as to those around him.
There may even be generational curses at work, so the actual adoption, lust,
death, etc. may have occurred many decades ago (coming full circle back to Bert
Hellinger, it seems), but affecting someone living today.

Who started this, I’d like to know? Whoever it was,
it’s clear that all these stories are versions of religious beliefs. That’s why
it’s so repugnant to the believers to attempt to argue in terms of observable
events--- even when their stated beliefs are presented as if they come from the
observable.

I’ve been reading further in Ute Benz’s edited book Festhaltetherapien, which examines
various aspects of holding therapy as promulgated by Jirina Prekopova in Germany
and the Czech Republic and by Martha Welch in the United States. Today I want
to discuss Marika Sommerfeldt’s chapter on a weekend of family constellation
and holding therapy in Prekop’s style. Once again, I have to say that I have
not asked permission to translate or to post any of this material, so I will
summarize most of it and translate only a few passages. This translation, by
the way, is my own and my dictionary’s, and to paraphrase Mark Twain, it was “clawed
into English by unremitting toil.”

Sommerfeldt signed up for a therapy weekend as one
who had read about it and wanted to know more, but as an excuse for her
participation she invented a fictional grandchild who cried a great deal and
was difficult to comfort. The story she tells of this weekend is strongly
reminiscent of any “encounter group”, church-sponsored retreat, or (for those
who remember this) the National Training Labs events of the late ‘60s and ‘70s.
Each person has a story to tell and “shares” his or her difficulties with
others, a proceeding managed by several qualified and student therapists. These
self-revelations are followed by various group rituals and by individual
therapy sessions intended to ameliorate the problems.

Sommerfeldt seems to have brought to the weekend a
genuine willingness to observe, and a real interest in her fellow weekenders, combined
with common sense and a delicate sarcasm. To amuse herself when on her own, she
also brought a copy of Bulgakow’s The
master and Margarita, a novel in which “madness” and its treatment play
primary roles-- very appropriate for the
milieu in which she found herself. As
advised, she packed comfortable clothes in the expectation that participants
would be sweating.

Introductions over and stories told, with tears in
several cases, the first day of the workshop began with a ritual farewell to
accompanying children, who would be taken to be cared for by young people who
were students of special education or of theater [! JM]. All sang a song about
a mouse who was going on a trip around the world and all the things he packed.
(Sommerfeldt noted at this point that the organizers addressed everyone in the
familiar form, as if they were relatives or close friends.)

Further stories were told by the adults, some of
them having to do with marital conflict. Sommerfeldt noted “I was always asking
myself, how the others and I got to this level of intimacy. Perhaps this is
usual in group therapy. I don’t know, but I found it misplaced. The speakers
lost all restraint-- they cried and
sobbed. The therapist tried to calm them, but it seemed to me a mistake to
advise ‘deep breathing’ or ‘putting both feet on the floor to be grounded’. My
first impulse was to take these crying women in my arms and comfort them, but
perhaps this was also the wrong reaction. We were asked by Ralf [a therapist]
to explain what we expected from the weekend. The hopes were very great.”

A later ritual for the adults was to form two
circles, with men and children in the inner circle, women in the outer circle,
singing in alternation. The children sang the song about the mouse again,
following Jirina Prekop’s dictum that “children need rituals”.

An organizer then began a description of Bert
Hellinger’s family constellation therapy, without mentioning his name. She explained
the family hierarchy and the order of places of father, mother, children, and
grandparents. The father is always at the top of the hierarchy because he determines the
descent of the children. For example, she said, if a mother is from Saxony and
a father is French, their daughter will also be French. Sommerfeldt commented, “It’s
never occurred to me in this way. The father of my children is of Saxon
background, but he considers himself a Berliner, because he was born in Berlin.
My children will not be too pleased when they hear that after this workshop
they are no longer Berliners.”

The organizer also stated that the order of
relationships remains the same even if the parents divorce. If the order is
broken, the child feels unprotected and becomes oppositional and tyrannical. If
the mother has conflicts with her own mother, the child will take over and
display the conflicts. Indeed, it was said, there is a “seventh sense” and an
instinct by which when the child sees her own mother in her child, the child
cannot love her. Sommerfeldt commented, “this speech seemed to me completely
confused, I simply couldn’t understand it.”

Now Sommerfeldt had to give a more complete story of
the fictional crying grandchild. “No, mother and child were not separated after
birth, and the mother showed very affectionate concern for the child, so ‘Philip’
was not suffering from a maternal deprivation syndrome, and no, the family’s relationships
were not disturbed. Nor did the child go to day care. The rest of the extended
family was somewhat odd.” The therapist Maximilian created a family tree, then
he explained. “My problems obviously came from my father’s first wife, who had
never been welcomed by the family and who died a long time ago. I understood
that my grandchild cried a lot because my father never talked about his first
wife and she no longer belonged to our kindred. Confusion had been brought into
the family order. My mother, my sister, and I had profited from the abandonment of the first wife and must
thank her for this and bow before her sad fate. … I was happy when my therapy
hour was at an end.”

Subsequently, Sommerfeldt asked with some
trepidation (brave woman!) for holding therapy. This was presented as being done
in a modified form, and was done by several therapists rather than by a person
with whom she was at odds [this seems to me contrary to what Prekop advises,
but I suppose the arrangements are made to suit each case. JM]. It was done in
her bedroom at the conference hotel, and a point was made of doing the holding
on an extra bed, not on the bed she slept in. She was asked to sit leaning
against a woman therapist, with her head on the other woman’s shoulder, and was
advised that she should not talk and question and that her failure to understand
with her heart was a cause of problems. Memories stored in the body were also
mentioned. Rather than lasting to
exhaustion, as seems to be recommended for children, the holding sessions
stopped after about an hour.

The weekend continued with various ritual performances,
such as pretending to be hedgehogs in a nest, and concluded with a candle-lighting
ceremony in which candles were to be dedicated to those each person loved.
Sommerfeldt commented that she found the ceremony ludicrous, but others found
it calming and good to do.

Sommerfeldt was left with affectionate feelings
toward the other participants and felt she would like to stay in touch with
some. “When I left, my daughter was already waiting at the exit. She
immediately asked me how it had been. By this time I really had holding therapy
and constellations or whatever they’re called up my nose. I told her, I don’t want
to talk about it now-- and didn’t stop
talking until we got to Berlin.”

There are many more details that I’ve skipped, and
this chapter is a real contribution to understanding of holding therapies and
of the involvement of Hellinger’s ideas in the Prekop system.

Wednesday, December 4, 2013

A couple of weeks ago, I commented on an on-line
sample from a new German book, Festhaltetherapien:Ein
Plaedoyer gegen umstrittene Therapieverfahren, edited by Ute Benz. I have
now received a copy of the book and am making my way painfully through
it-- I began by looking up three words
in every paragraph and am now down to two for most paragraphs, and even an
occasional paragraph where (I think) I understand everything.

I didn’t begin at the beginning, but wanted to look
at a chapter by Ute Benz on the historical development of Holding Therapies
(pp. 121-143). (I should emphasize here that the title is in the plural, and
that although the book focuses to a considerable extent on the treatment as
done by Jirina Prekop and Martha Welch, in fact there are other methods that
use restraint on children in almost the same way as Prekop and Welch.) I am going to translate some parts of this
chapter, but I do want to note that I have not asked permission to do so. I
assume that the short sections I will present, and the fact that I have no
commercial interest here, will make this acceptable, but if there are any
objections from authors or publisher I will naturally take the post down.

I’ll begin with Benz’s description of Prekop’s
holding method, which its proponents recommend for autistic children, for
oppositional children, and for “any child who needs it”. “The picture of the classical
holding scene looks like this: a boy or girl sits or lies on a mat with the
entire body held tightly by adults, the mother and/or father and perhaps a
third or fourth helper, so that the child can no longer move, but can only cry
out. For the child to scream and cry during the procedure is considered normal
and even desirable as the expression of emotion belonging to the method, so
crying must be provoked if a child becomes compliant too quickly. This is to
dissolve repressions. The child’s crying is much more easily tolerated by the
parents when many children are treated and cry simultaneously. If a child
immediately becomes still and resigned to his fate or goes to sleep or looks
around the room, he is practicing a defense against the treatment and must be
provoked in order to break through the defense.”

“When Holding Therapy is done in the home, the
parents are warned to close the windows, so that neighbors will not hear the
sound of screaming and call the police. Because the delaying tactics of the
restrained child may cause him to scratch, bite, hit, or kick, a certain
position needs to be taken, so there are no bruises as visible signs of
mistreatment. The child must cross his hands and legs in a sort of straitjacket
position and sit straddling the lap of the adult. His head must be laid or
pressed against the crook of the adult’s neck. … the child must not be let go
under any circumstances, such as begging, yelling, screaming , or desperately
crying, even if he needs to go to the toilet, his nose runs, or he becomes sick,
or when both bodies are bathed in sweat, or when the child trembles from stress
or is hungry or thirsty. All these things are done in typical evasive maneuvers [N.B. Benz is describing
Prekop’s viewpoint, not her own opinion!] that must be overcome in the course
of the process so that the goal of a tractable child is reached.” This goal is
shown when the child allows eye contact as the parents wish it, lets himself be
caressed, and says things like “I love you” or promises desired behavior. As Benz
notes later, this end is thought to justify the means.

Benz, who estimates 10,000 cases of this treatment
in Germany and Austria over the last 30 years, also notes people who have
contacted her to ask for help or explanations. (She also notes that few German
psychotherapists know about Holding Therapy or even know it exists.) In 2004,
she was contacted by a divorced father who had custody of a seven-year-old boy;
the boy was refusing to visit his mother. The boy told his father that the mother
would restrain him while he lay on the floor, would stroke him and whisper “I
am your mother, I love you.” Benz was also contacted by a town counselor who
was concerned about accusations of mistreatment against a staff member in a
children’s home, where there had already been repeated indications of trouble.
The accused person had already resigned, but the town council now needed to
review over a hundred videotapes although they did not know anything about the
theory and practice of Holding Therapy. In 2011 Benz was contacted by a
27-year-old woman from the Netherlands, who had been given intensive Holding
Therapy for years as treatment for cerebral palsy. For the first four years
holding was done three times a day, which was later reduced to three times a
week. At age 20 she had serious problems with being near other people and with
physical contact. Her doctor advised her to seek therapy but could not say
where to go.

Benz describes a number of similar cases who have
contacted her, but as far as I have read does not suggest specific techniques
for treating these effects of Holding Therapy, although she does note that
practitioners need to explore whether new patients have been subjected to this
treatment. As I have noted before, in one case I know in the United States, a
young woman who as a child was subjected to treatment of the Prekop-Welch type
suffered increasingly severe anxiety attacks in her 20s, but was relieved by
desensitization treatment focusing on her memories of the treatment, particularly
the screams of other children in the room.

I must say that distressing as I find treatment of
this type for autistic children, the idea of trying to apply it to someone with
cerebral palsy is really beyond anything I have encountered before. One wonders
whether these people would use holding for appendicitis! Surely declarations of
intense pain and vomiting could be interpreted as defensive delaying actions,
too … and no doubt similar interpretations have been made by some practitioners.

In a later post, I want to go into what Benz has to
say about the use of similar techniques by occupational therapists in Germany.

Wednesday, November 27, 2013

I hate the term Parental Alienation Syndrome (PAS).
Of course a parent can do and say things that encourage children to feel
alienated from the other parent (just as
a parent can do or say things that alienate children from himself or herself).
Children can be alienated to a greater or lesser degree by many factors, and I
would hazard the guess that all children at all times have some preference for
one parent over the other, although the preference may change with age and
events. When parents separate or divorce, it would be virtuous for both of them
to remember what they used to like about the other parent, and to encourage the
children to maintain a positive relationship. Some people do the opposite, but their actions
and the children’s responses are not part of a “syndrome”, a term that tries to
sound as if there is solid scientific evidence behind the use of the PAS label.

A lot of people other than myself have also rejected
the PAS concept. As a result, instead of accusing a divorcing co-parent of
causing the children’s alienation, there may be an accusation of failing to
promote the children’s relationship with the other parent. When the accused
parent denies that this was the case, the conclusion may be that he or she is “in
denial” and must go into therapy in order to acknowledge the actions and
understand the reason for them. It may be ruled that until this is
accomplished, there can be little or no contact with the children.( I am
wondering, by the way, whether a request that the other parent have supervised
rather than unsupervised visitation may be enough to trigger the accusation.)

This does not leave much of an option for a person
who actually did not fail to promote the relationship, does it?

I have in mind two cases that almost exactly
followed this pattern, and one other that has some similarities. All are cases
where a parent denies having done what she is accused of (they all happen to be
“she”), and is sent for therapy to enable her to “confess”, and, I suppose, be
shriven. If she really did wrong, of course, this speaks badly for her
character, so she should not have much contact; if she says she didn’t, that
means she’s lying, confused,or mentally ill, so again she should not have much
contact. To be accused is to be convicted, it would appear.

In one case in Canada, the parents separated when
the children were about one and two years old. The mother asked for supervised visitation
with the father, who sought the help of a psychotherapy group. Father’s attorney claimed Parental Alienation
Syndrome and full custody was given to the father, with the order that mother must
undergo psychotherapy in order to acknowledge her alienating behavior and treat
whatever problem caused it. Until this is done she is not to have contact with
the children, nor may her parents see them. Mother denies having caused
alienation and argues that if the children are alienated, it is father’s own
behavior that has done this. The costs of psychotherapy are in any case impossible
for her to pay.

In a second case in the U.S., the parents separated
when the children were almost two and almost 4, following revelations of father’s
use of prostitutes. Father did not want to divorce. Mother asked for supervised
visitation because father had allowed one child to play with an electronic
device on which father had downloaded pornography. Mother took the children to
her family’s home in Canada, while father petitioned a U.S court for custody.
Mother has just been told that custody is to be given to the father because she
failed to promote the father-child relationship during the separation, and that
she must go into therapy so she can acknowledge and work through the problem. The
children must go to their father by Jan. 1, giving them one month to prepare
for this major change. If mother stays where she is, she may see the children
once a month and Skype with them every other day (a decision that ignores the
usual recommendation for overnights equivalent in number to the child’s age in
years); if she follows the court’s directive and also moves to the father’s
chosen city, she may have 50/50 custody. She denies that she failed to promote
the relationship.

The third case is different, and I have written
about it here before (http://childmyths.blogspot.com/2013/01/kafka-again-more-on-capture-of-child.html).
In this case, the mother asked a couple (the man being the father of one of her
children) to care for two preschoolers for some days. When she returned, the
couple refused to give them up. Years have passed in a legal battle over this
which has taken all of mother’s savings. The children have been in an
unconventional form of therapy and one is in residential treatment against mother’s
wishes. The therapists say, and the courts agree, that the mother must have
been abusive, because the children are in problematic mental health; nothing in
their early medical or educational records indicates this. The mother denies
that she was neglectful or abusive, and this is interpreted as evidence that
she must have been so. The plan at this point appears to be to terminate her
parental rights and to “free” one of the children for adoption by an as yet
unknown family.

Do all these cases remind anyone of anything? For
me, they are quite reminiscent of the Recovered Memory Therapy scandal of the ‘90s,
in which failure to remember sexual abuse was counted as evidence of abuse, as
heavily or more so than memories. Accused parents who denied abuse were also
told that they certainly could not see their children unless they confessed
their misdeeds; those who confessed falsely out of desperation (or were
convinced that their lack of memory meant they were guilty) could still not be
with the children and often lost their jobs and other resources as well.

It’s time that the courts dropped the ‘70s pop
psychology belief that denying something is evidence that it’s true. Honestly, life
isn’t all in our unconscious minds and motivations. And a reality-based request
for supervised visitation is not alienation, in any case.

Last weekend, my husband and I visited friends in
another state, a family that has one 9-year-old child, a boy adopted from Latin
America when he was 11 months old. On Monday morning, I saw an interesting
little scene: before young Phineas (which I’ll call him because it’s pretty obvious
that it isn’t his name) was about to leave for the school bus, his mother
called him to give goodbye kisses to my husband and me, because we were about
to go home, and then she wanted a hug and kiss for herself. Phineas came to her
and let her put her arms around him, but he turned his face away with a blank, withdrawn
expression and did not participate.

I was struck by the resemblance between Phineas’s
behavior and the failure to be affectionate “on the parent’s terms” that
proponents of Attachment Therapy regard as a symptom of Reactive Attachment Disorder (or of their
notional entity, Attachment Disorder). And of course there were various other
cherries that could be picked to build support for this diagnosis: separation
from the birth mother very early; care by a foster family, then separation from
them for placement with his adoptive parents. He even had to be told not to be
quite so rough with the dog on Sunday afternoon.

So,shall we jump to the conclusion that Phineas is a
sad case of RAD, or AD? Let me offer some alternative explanatory factors.

First, let me point out that nine is an age when
most children begin to look outward from the family and concern themselves less
with their parents and more with their peers. The hugs and kisses that they
used to like so much now become more formalized, except perhaps at bedtime.
Rough-and-tumble play is very much part of their lives, and they may need to be
reminded that pets don’t communicate in the same ways their friends do.

In addition, Phineas’s life has had some bumps in it
over the last two years. His developmental pathway had been very smooth in
every way, until two events occurred a couple of years ago. The first was that
his mother, who is a medical professional, developed an allergy to latex that was
of life-threatening proportions. If Phineas had touched rubber bands or latex balloons
and then touched her or kissed her, she had a reaction that required a visit to
the emergency room, often, of course, with Phineas in tow. Even a visit to a
store that had a display of latex balloons could do this, and Phineas became a
balloon-detecter, looking around him carefully as they entered each new place.
On a couple of occasions, balloons at Phineas’s school meant that his mother
had to leave quickly, and there was much correspondence as the mother asked
school staff to help her by excluding latex balloons . If the balloons were
there, she could not go to the school for classroom visits or parties or many of
the events other parents attended (and Phineas’s father’s job rarely gave him
the chance to do these things).

At that point, Phineas received a head injury in a
playground accident and suffered from post-concussion syndrome that continued
over more than a year. He could not tolerate loud noises or crowds, cried
easily, and was afraid of another blow to his head. His school attendance had
to be managed carefully. And of course this was all complicated by the fact
that his mother could not go with him to a doctor’s office unless she knew it
was latex-safe, so even his medical care had additional complications. (He also
had a medical problem involving a mass on a testicle, which fortunately
resolved without further treatment.)

Last summer, just as the effects of the concussion
finally seemed to be over, two elderly, much-loved members of the family died,
and Phineas’s maternal grandmother had two heart attacks. To help deal with
this, his mother went away for two weeks at a time to the neighboring state
where her mother lives, leaving Phineas with his father-- the best possible situation for him, but also
the first real separation he had had from her.

A week ago, Phineas’s school started a new
fund-raising project, making and selling necklaces made of stretchy
bands-- latex, of course. His mother
told him she would be fine if he did that as long as he changed his clothes
when he came home and put them in the washer so she did not have to touch them.
But on the school bus he had to sit next to a boy who tends to bully, and when
the boy pulled out his rubber bands, Phineas told him “don’t touch me with
those, I don’t want to get latex on me. It makes my mother sick. She might even
die.” The other child, not surprisingly for him, took this as provocation and
rubbed the bands all over Phineas’s shirt, saying “I’m killing your mother!”.
Phineas got off the bus in a storm of tears and told his mother “I don’t want
you to die! Please don’t die!”

A few days later, Phineas turned his head away when
his mother wanted to kiss him goodbye before he went to school. Do we have to
look to an attachment disorder to explain this? I think not! This child is
intensely attached to his mother, and not unrealistically afraid of losing her.
What can he possibly do to feel better about this? His only option is to try to
avoid the vulnerability he feels-- or at
least to try to act as if he isn’t vulnerable. To interpret this behavior as
meaning a lack of attachment would be absurd, and to attempt to treat it by
placing him in “therapeutic foster care” would simply exacerbate his fear.

Am I saying that there is no such thing as Reactive
Attachment Disorder? Not exactly; I think there are behaviors of quite young
children that stem from disturbed attachment relationships. But when we see
years of typical development, and then “aloofness” in family relationships, I
believe we do well to examine these in the context of all the child’s
experiences, both early and recent. Most contextual factors may not be as
obvious as they are in Phineas’s case, but they need to be searched for before
we assume that attachment is the problem.

About Me https://en.wikipedia.org/wiki/Jean_Mercer

Jean Mercer has a Ph.D in Psychology from Brandeis University, earned when that institution was 20 years old (you do the math). She is Professor Emerita of Psychology at Richard Stockton College, where for many years she taught developmental psychology, research methods, perception, and history of psychology. Since about 2000 her focus has been on potentially dangerous child psychotherapies, and she has published several related books and a number of articles in professional journals.
Her CV can be seen at http://childmyths.blogspot.com/2009/12/curriculum-vitae-jean.mercer-richard.html.